Résumé
Clinical data from 175 patients with squamous cell carcinoma of the oesophagus or cardia admitted to Songklanagarind Hospital between 1982 and 1988 were analysed to evaluate the effects on survival of various tumour and treatment variables. Most tumours (greater than = 86%) were in stage III or IV. Forty-seven percent of stage-IV tumours and 99 per cent of those in stages I, II or III were resectable. One-year and 3-year survival rates of resected stage-III patients (57.3% and 27.5%) were significantly higher than those of resected stage-IV patients (33.3% and 0%). Resection conferred no benefit over radiotherapy chemotherapy or no treatment on the survival of stage-IV cases beyond one year. Combined chemotherapy/radiotherapy/resection of stage-III and stage-IV patients gave no statistically significant improvement in survival. Among resected patients, only lymph node involvement was associated with significantly lower survival (relative risk compared to no involvement = 2.3, 95% CL: 1.2, 4.6), while the fungating type of tumour was possibly associated with improved survival (relative risk compared with all other types = 0.24, 95% CL: 0.05, 1.1).
Sujets)
Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Carcinome épidermoïde/épidémiologie , Association thérapeutique , Tumeurs de l'oesophage/épidémiologie , Femelle , Études de suivi , Hôpitaux universitaires , Humains , Mâle , Adulte d'âge moyen , Stadification tumorale , Facteurs de risque , Taux de survie , Thaïlande/épidémiologieRésumé
The use of balloon cytology technique for detection of oesophageal carcinoma has been tested in 73 non-symptomatic patients and 53 patients with symptoms of oesophageal carcinoma from the high incidence of Southern Thailand. Cytological findings were compared with findings of esophagoscopy and oesophageal biopsy. Among symptomatic patients, scope/biopsy revealed 29 positive for carcinoma, against which balloon cytology yielded 9 false negatives (sensitivity 69%), but no false positives. All false negatives were of the stenosing type of tumour. One of 3 early cases of carcinoma revealed by the balloon technique among asymptomatic patients could not be detected by oesophagoscopy, biopsy or oesophagogram, but was confirmed by repeated cytological examination. The basic properties of the balloon cytology technique appear to justify its use as a routine diagnostic tool among high-risk patients for oesophageal carcinoma in Southern Thailand.